Ask Our Doctors – Archive

Our Medical Directors are outstanding physicians that you will find to be very personable and compassionate, who take care to ensure that you have the most cutting-edge fertility treatments at your disposal. This is your outlet to ask your questions to the doctors.

19,771 Comments

  1. Hello Dr Sher!
    I need your help. I have very high fsh and undetectable AMH. I am 40 years old but not willing to give up.
    I had a period on June 1st and then after 2 weeks i had a period again. I have been doing blood tests all these past few days trying to determine if i have ovulated but i can’t tell. Can you please take a look at my results and please tell me whether i have ovulated??
    Period day 1 = 16th June
    day 2= FSH 49 LH=54.20 E2=28.9 P4=0.59nmols
    day 7= LH=55.43 E2=49.1 P4= o.83
    day 8= LH=55.80 E2=53.8 P4=4.28
    day 9= LH=56.95 E2=65.3 P4=6.09
    day 10= LH=52.76 E2=82.8 P4=5.65
    day 12= LH=74.35 E2=89.9 P4=6.27
    day 13= LH=61.90 E2=96.1 P4=4.34
    day 14= LH=79.91 E2=110.8 P4=5.97
    day 16= LH=65.80 E2=125.7 P4=10.56
    day 18= LH=72.18 E2=119.2 P4=12.43

    progesterone = follicular 0.60-4.70nmols/l
    luteal 5.30-86.00
    ovulation 2.40-9.40
    Please note that i may have a cyst or cysts as i feel pain but will have an ultrasound to confirm soon.

    1)My fsh has never climbed so high before.Is this a true reading given that i had a period 15 days after the previous one?
    2) And most importantly-given the blood tests above, have i ovulated this cycle and if so on which day??

    Waiting desperately to hear from you as i am planning to start estrogen priming one week after ovulation. I don’t want to make a mistake and if i haven’t ovulated i might as well wait till next cycle.
    Thanks so much for reading this(please do not advice donor eggs as i still want to do a few final tries with my own). Thank you.

    • Based upon the patern, I suspect that you did not ovulate….It looks more like premature luteinization probably with unruptured follicle. Your elevated FSH suggests a significant degree of diminished ovarian reserve.

      Women who (regardless of age) have diminished ovarian reserve (DOR) tend to produce fewer and less “competent” eggs, the main reason for reduced IVF success in such cases. The compromised outcome is largely due to the fact that such women tend to have increased LH biological activity which often results in excessive LH-induced ovarian testosterone production which in turn can have a deleterious effect on egg/embryo “competency”.
      Certain ovarian stimulation regimes either promote excessive LH production (e.g. short agonist/Lupron- “flare” protocols, clomiphene and Letrozole), augment LH/hCG delivered through additional administration (e.g. high dosage menotropins such as Menopur), or fail to protect against body’s own/self-produced LH (e.g. late antagonist protocols where drugs such as Ganirelix/Cetrotide/Orgalutron that are first administered 6-7 days after ovarian stimulation has commenced).
      I try to avoid using such protocols/regimes (especially) in older women and those with DOR, favoring instead the use of a modified, long pituitary down-regulation protocol (the agonist/antagonist conversion protocol-A/ACP) augmented by adding supplementary human growth hormone (HGH). I further recommend Staggered IVF with embryo banking of PGS (next generation gene sequencing/NGS)-normal blastocysts in such cases. This type of approach will in my opinion, optimize the chance of a viable pregnancy per embryo transfer procedure and provide an opportunity to capitalize on whatever residual ovarian reserve and egg quality still exists, allowing the chance to “make hay while the sun still shines”.
      Please visit my new Blog on this very site, http://www.DrGeoffreySherIVF.com, find the “search bar” and type in the titles of any/all of the articles listed below, one by one. “Click” and you will immediately be taken to those you select. Please also take the time to post any questions or comments with the full expectation that I will (as always) respond promptly
      •Controlled Ovarian Stimulation (COS) for IVF: Selecting the ideal protocol
      •IVF: Factors Affecting Egg/Embryo “competency” during Controlled Ovarian Stimulation(COS)
      •The Fundamental Requirements For Achieving Optimal IVF Success
      •Ovarian Stimulation for IVF using GnRH Antagonists: Comparing the Agonist/Antagonist Conversion Protocol.(A/ACP) With the“Conventional” Antagonist Aproach
      •Anti Mullerian Hormone (AMH) Measurement to Assess Ovarian Reserve and Design the Optimal Protocol for Controlled Ovarian Stimulation (COS) in IVF.
      •The “Biological Clock” and how it should Influence the Selection and Design of Ovarian Stimulation Protocols for IVF.
      • A Rational Basis for selecting Controlled Ovarian Stimulation (COS) protocols in women with Diminished Ovarian Reserve (DOR)
      •Diagnosing and Treating Infertility due to Diminished Ovarian Reserve (DOR)
      •Controlled Ovarian Stimulation (COS) in Older women and Women who have Diminished Ovarian Reserve (DOR): A Rational Basis for Selecting a Stimulation Protocol
      •Human Growth Hormone Administration in IVF: Does it Enhances Egg/Embryo Quality and Outcome?
      •The BCP: Does Launching a Cycle of Controlled Ovarian Stimulation (COS). Coming off the BCP Compromise Response?
      •Blastocyst Embryo Transfers Should be the Standard of Care in IVF
      •Frozen Embryo Transfer (FET) versus “Fresh” ET: How to Make the Decision
      •Frozen Embryo Transfer (FET): A Rational Approach to Hormonal Preparation and How new Methodology is Impacting IVF.
      •Staggered IVF: An Excellent Option When. Advancing Age and Diminished Ovarian Reserve (DOR) Reduces IVF Success Rate
      •Embryo Banking/Stockpiling: Slows the “Biological Clock” and offers a Selective Alternative to IVF-Egg Donation.
      •Preimplantation Genetic Testing (PGS) in IVF: It Should be Used Selectively and NOT be Routine.
      •Preimplantation Genetic Sampling (PGS) Using: Next Generation Gene Sequencing (NGS): Method of Choice.
      •PGS in IVF: Are Some Chromosomally abnormal Embryos Capable of Resulting in Normal Babies and Being Wrongly Discarded?
      •PGS and Assessment of Egg/Embryo “competency”: How Method, Timing and Methodology Could Affect Reliability
      •Treating Out-of-State and Out-of-Country Patients at Sher-IVF in Las Vegas:
      •Traveling for IVF from Out of State/Country–
      •A personalized, stepwise approach to IVF
      •How Many Embryos should be transferred: A Critical Decision in IVF.
      •The Role of Nutritional Supplements in Preparing for IVF
      •Premature Luteinization (“the premature LH surge): Why it happens and how it can be prevented.
      •IVF Egg Donation: A Comprehensive Overview
      I invite you to arrange to have a Skype or an in-person consultation with me to discuss your case in detail. If you are interested, please contact Julie Dahan, at:

      Email: Julied@sherivf.com

      OR

      Phone: 702-533-2691
      800-780-7437

      I also suggest that you access the 4th edition of my book ,”In Vitro Fertilization, the ART of Making Babies”. It is available as a down-load through http://www.Amazon.com or from most bookstores and public libraries.

      Geoff Sher

  2. Hi ,

    I underwent ivf two months ago which had to be cancelled after egg retrieval due to elevated progesterone . My stims were menpur with cetritotode introduced to stop ovulation. I am 41 . Embryos were frozen for a fet . I had my fet last two months which failed and was gearing up for another fet when I got a funny spotty period and went for a scan which found one cyst.!that was two weeks ago and I am due for a scan to check if it’s gone naturally. My fet cycle was medicated by the way with estrogen and progestan with cetrotode. Could you let me know your thoughts on probable cause of my cyst.

    • I cannot comment authoritatively on the the reason for the cyst. I would need much more information first.

      I invite you to arrange to have a Skype or an in-person consultation with me to discuss your case in detail. If you are interested, please contact Julie Dahan, at:

      Email: Julied@sherivf.com

      OR

      Phone: 702-533-2691
      800-780-7437

      I also suggest that you access the 4th edition of my book ,”In Vitro Fertilization, the ART of Making Babies”. It is available as a down-load through http://www.Amazon.com or from most bookstores and public libraries.

      Geoff Sher

  3. Dear Dr.Sher,

    We would love your advice:

    I’m 40, healthy weight, non-smoker etc., my FSH is 5.4 and my AMH Is 1.4. We have one 3 year old conceived naturally with no complications. Experiencing very frustrating secondary infertility. In the past year we have tried ART: One IUI resulted in ectopic pregnancy (emergency surgery to remove Fallopian tube); 1st IVF cycle (antagonist protocol) yielded 4 good quality 5-day blastocysts, which were sadly all found to be abnormal after PGS testing; 2nd round IVF five 5-day blastocysts, and 3 normal PGS tested embryos frozen! Very pleased with this….
    Our RE gave us 60% chance with each embryo.
    However the first two FETs have now failed. Their FET protocol is estrace (from CD3) and progesterone shots beginning 5 days before transfer, medrol for 5 days before transfer, and one dose of azith. 5 days before transfer.
    Each time my lining has been more than 8mm (last time 9.5) and hormone levels have been “perfect” (prog more than 40 etc)

    We are so nervous about this last FET. I don’t think they will offer any additional tests or medications… Is this just bad luck? What more should we ask for, or about? We are now so pessimistic about this working and feel like our time is running out (I’ll be 41 in the fall).

    Any advice is appreciated,
    Rebecca

    • At 40Y of age with diminishing ovarian reserve you need IVF with embryo banking. More importantly, the protocol used for ovarian reserve needs to be reviewed/revised.

      Women who (regardless of age) have diminished ovarian reserve (DOR) tend to produce fewer and less “competent” eggs, the main reason for reduced IVF success in such cases. The compromised outcome is largely due to the fact that such women tend to have increased LH biological activity which often results in excessive LH-induced ovarian testosterone production which in turn can have a deleterious effect on egg/embryo “competency”.
      Certain ovarian stimulation regimes either promote excessive LH production (e.g. short agonist/Lupron- “flare” protocols, clomiphene and Letrozole), augment LH/hCG delivered through additional administration (e.g. high dosage menotropins such as Menopur), or fail to protect against body’s own/self-produced LH (e.g. late antagonist protocols where drugs such as Ganirelix/Cetrotide/Orgalutron that are first administered 6-7 days after ovarian stimulation has commenced).
      I try to avoid using such protocols/regimes (especially) in older women and those with DOR, favoring instead the use of a modified, long pituitary down-regulation protocol (the agonist/antagonist conversion protocol-A/ACP) augmented by adding supplementary human growth hormone (HGH). I further recommend Staggered IVF with embryo banking of PGS (next generation gene sequencing/NGS)-normal blastocysts in such cases. This type of approach will in my opinion, optimize the chance of a viable pregnancy per embryo transfer procedure and provide an opportunity to capitalize on whatever residual ovarian reserve and egg quality still exists, allowing the chance to “make hay while the sun still shines”.
      Please visit my new Blog on this very site, http://www.DrGeoffreySherIVF.com, find the “search bar” and type in the titles of any/all of the articles listed below, one by one. “Click” and you will immediately be taken to those you select. Please also take the time to post any questions or comments with the full expectation that I will (as always) respond promptly

      •Controlled Ovarian Stimulation (COS) for IVF: Selecting the ideal protocol
      •IVF: Factors Affecting Egg/Embryo “competency” during Controlled Ovarian Stimulation(COS)
      •The Fundamental Requirements For Achieving Optimal IVF Success
      •Ovarian Stimulation for IVF using GnRH Antagonists: Comparing the Agonist/Antagonist Conversion Protocol.(A/ACP) With the“Conventional” Antagonist Aproach
      •Anti Mullerian Hormone (AMH) Measurement to Assess Ovarian Reserve and Design the Optimal Protocol for Controlled Ovarian Stimulation (COS) in IVF.
      •The “Biological Clock” and how it should Influence the Selection and Design of Ovarian Stimulation Protocols for IVF.
      • A Rational Basis for selecting Controlled Ovarian Stimulation (COS) protocols in women with Diminished Ovarian Reserve (DOR)
      •Diagnosing and Treating Infertility due to Diminished Ovarian Reserve (DOR)
      •Controlled Ovarian Stimulation (COS) in Older women and Women who have Diminished Ovarian Reserve (DOR): A Rational Basis for Selecting a Stimulation Protocol
      •Human Growth Hormone Administration in IVF: Does it Enhances Egg/Embryo Quality and Outcome?
      •The BCP: Does Launching a Cycle of Controlled Ovarian Stimulation (COS). Coming off the BCP Compromise Response?
      •Blastocyst Embryo Transfers Should be the Standard of Care in IVF
      •Frozen Embryo Transfer (FET) versus “Fresh” ET: How to Make the Decision
      •Frozen Embryo Transfer (FET): A Rational Approach to Hormonal Preparation and How new Methodology is Impacting IVF.
      •Staggered IVF: An Excellent Option When. Advancing Age and Diminished Ovarian Reserve (DOR) Reduces IVF Success Rate
      •Embryo Banking/Stockpiling: Slows the “Biological Clock” and offers a Selective Alternative to IVF-Egg Donation.
      •Preimplantation Genetic Testing (PGS) in IVF: It Should be Used Selectively and NOT be Routine.
      •Preimplantation Genetic Sampling (PGS) Using: Next Generation Gene Sequencing (NGS): Method of Choice.
      •PGS in IVF: Are Some Chromosomally abnormal Embryos Capable of Resulting in Normal Babies and Being Wrongly Discarded?
      •PGS and Assessment of Egg/Embryo “competency”: How Method, Timing and Methodology Could Affect Reliability
      •Treating Out-of-State and Out-of-Country Patients at Sher-IVF in Las Vegas:
      •Traveling for IVF from Out of State/Country–
      •A personalized, stepwise approach to IVF
      •How Many Embryos should be transferred: A Critical Decision in IVF.
      •The Role of Nutritional Supplements in Preparing for IVF
      •Premature Luteinization (“the premature LH surge): Why it happens and how it can be prevented.
      •IVF Egg Donation: A Comprehensive Overview
      I invite you to arrange to have a Skype or an in-person consultation with me to discuss your case in detail. If you are interested, please contact Julie Dahan, at:

      Email: Julied@sherivf.com

      OR

      Phone: 702-533-2691
      800-780-7437

      I also suggest that you access the 4th edition of my book ,”In Vitro Fertilization, the ART of Making Babies”. It is available as a down-load through http://www.Amazon.com or from most bookstores and public libraries.

      Geoff Sher

  4. Hello Dr –

    Hubby and I are 32 and have had 2 ETs and 2 FETs. Doctor has said I am more than likely a poor responder. My first ET I stimmed for 12 days, had 8 follicles, 4 retrieved, 3 fertilized and 2 frozen – 4BB and 5BB-. We decided to retrieve again with a micro flare protocol, again for 12 days. We had 16 follicles and yet only 4 eggs retrieved and no resulting embryos. We decided to proceed with the FETs to give them a chance. The first transfer resulted in a chemical (4 positive HpTs and a negative beta). The second failed.

    In both FETs I had liquid in the uterus which cleared up when starting the progesterone.

    I have not had natural cycles since stopping birth control in late 2013.

    All hormone levels appear normal – so my response has been a mystery to me and my RE. I have had a history of on and off again positive ANA.

    I am trying to determine what my next steps should be. Do I seek out another RE? Give her another try? Is an estrogen priming protocol perhaps more appropriate given my history? Looking for guidance on next steps. We are not opposed to going out of state and we have fantastic insurance. We are too young to give up. Thank you in advance for your guidance.

    Best,

    AKM

    • Older women as well as those who (regardless of age) have diminished ovarian reserve (DOR) tend to produce fewer and less “competent” eggs, the main reason for reduced IVF success in such cases. The compromised outcome is largely due to the fact that such women tend to have increased LH biological activity which often results in excessive LH-induced ovarian testosterone production which in turn can have a deleterious effect on egg/embryo “competency”.
      Certain ovarian stimulation regimes either promote excessive LH production (e.g. short agonist/Lupron- “flare” protocols, clomiphene and Letrozole), augment LH/hCG delivered through additional administration (e.g. high dosage menotropins such as Menopur), or fail to protect against body’s own/self-produced LH (e.g. late antagonist protocols where drugs such as Ganirelix/Cetrotide/Orgalutron that are first administered 6-7 days after ovarian stimulation has commenced).
      I try to avoid using such protocols/regimes (especially) in older women and those with DOR, favoring instead the use of a modified, long pituitary down-regulation protocol (the agonist/antagonist conversion protocol-A/ACP) augmented by adding supplementary human growth hormone (HGH). I further recommend Staggered IVF with embryo banking of PGS (next generation gene sequencing/NGS)-normal blastocysts in such cases. This type of approach will in my opinion, optimize the chance of a viable pregnancy per embryo transfer procedure and provide an opportunity to capitalize on whatever residual ovarian reserve and egg quality still exists, allowing the chance to “make hay while the sun still shines”.
      Please visit my new Blog on this very site, http://www.DrGeoffreySherIVF.com, find the “search bar” and type in the titles of any/all of the articles listed below, one by one. “Click” and you will immediately be taken to those you select. Please also take the time to post any questions or comments with the full expectation that I will (as always) respond promptly
      •Controlled Ovarian Stimulation (COS) for IVF: Selecting the ideal protocol
      •IVF: Factors Affecting Egg/Embryo “competency” during Controlled Ovarian Stimulation(COS)
      •The Fundamental Requirements For Achieving Optimal IVF Success
      •Ovarian Stimulation for IVF using GnRH Antagonists: Comparing the Agonist/Antagonist Conversion Protocol.(A/ACP) With the“Conventional” Antagonist Aproach
      •Anti Mullerian Hormone (AMH) Measurement to Assess Ovarian Reserve and Design the Optimal Protocol for Controlled Ovarian Stimulation (COS) in IVF.
      •The “Biological Clock” and how it should Influence the Selection and Design of Ovarian Stimulation Protocols for IVF.
      • A Rational Basis for selecting Controlled Ovarian Stimulation (COS) protocols in women with Diminished Ovarian Reserve (DOR)
      •Diagnosing and Treating Infertility due to Diminished Ovarian Reserve (DOR)
      •Controlled Ovarian Stimulation (COS) in Older women and Women who have Diminished Ovarian Reserve (DOR): A Rational Basis for Selecting a Stimulation Protocol
      •Human Growth Hormone Administration in IVF: Does it Enhances Egg/Embryo Quality and Outcome?
      •The BCP: Does Launching a Cycle of Controlled Ovarian Stimulation (COS). Coming off the BCP Compromise Response?
      •Blastocyst Embryo Transfers Should be the Standard of Care in IVF
      •Frozen Embryo Transfer (FET) versus “Fresh” ET: How to Make the Decision
      •Frozen Embryo Transfer (FET): A Rational Approach to Hormonal Preparation and How new Methodology is Impacting IVF.
      •Staggered IVF: An Excellent Option When. Advancing Age and Diminished Ovarian Reserve (DOR) Reduces IVF Success Rate
      •Embryo Banking/Stockpiling: Slows the “Biological Clock” and offers a Selective Alternative to IVF-Egg Donation.
      •Preimplantation Genetic Testing (PGS) in IVF: It Should be Used Selectively and NOT be Routine.
      •Preimplantation Genetic Sampling (PGS) Using: Next Generation Gene Sequencing (NGS): Method of Choice.
      •PGS in IVF: Are Some Chromosomally abnormal Embryos Capable of Resulting in Normal Babies and Being Wrongly Discarded?
      •PGS and Assessment of Egg/Embryo “competency”: How Method, Timing and Methodology Could Affect Reliability
      •Treating Out-of-State and Out-of-Country Patients at Sher-IVF in Las Vegas:
      •Traveling for IVF from Out of State/Country–
      •A personalized, stepwise approach to IVF
      •How Many Embryos should be transferred: A Critical Decision in IVF.
      •The Role of Nutritional Supplements in Preparing for IVF
      •Premature Luteinization (“the premature LH surge): Why it happens and how it can be prevented.
      •IVF Egg Donation: A Comprehensive Overview
      I invite you to arrange to have a Skype or an in-person consultation with me to discuss your case in detail. If you are interested, please contact Julie Dahan, at:

      Email: Julied@sherivf.com

      OR

      Phone: 702-533-2691
      800-780-7437

      I also suggest that you access the 4th edition of my book ,”In Vitro Fertilization, the ART of Making Babies”. It is available as a down-load through http://www.Amazon.com or from most bookstores and public libraries.

      Geoff Sher

  5. Hello Dr Sher,

    I am 34 year old woman. I had IVF due to premature ovarian failure. I initially went through IVF in Jan 2016 at which time 5 eggs were retrieved our of which 4 fertilized but none could be frozen. I had IVF again in March 2016 at which time 8 eggs were retrieved out of which 8 fertilized but 3 were frozen. I had transfer of two 5 day embryos on 6/17/16. 1 embryo was excellent quality and 1 was good quality.I have been taking Estrace twice a day and endometrin My first Beta HCG was 374 on 6/27/16. My 2nd beta HCG on 6/29/16 dropped to 363 on 6/29/16. My 3rd beta HCG on 7/1/16 dropped to 312. My doctor adviced me that I can stop taking the meds as my pregnancy has failed. Since my beta HCG was still above 300, after discussion with my doctor, I decided to continue taking the medications for now and have my beta HCG rechecked on 7/5/16. I know in the light of my decreasing beta HCG levels my pregnancy has likely failed. Are there any chances the drop in my HCG could be due to a vanishing twin and I could still have one surviving embryo that could be producing beta HCG at a slower rate?

    • Yes! it is possible but not likely!

      Women who (regardless of age) have diminished ovarian reserve (DOR) tend to produce fewer and less “competent” eggs, the main reason for reduced IVF success in such cases. The compromised outcome is largely due to the fact that such women tend to have increased LH biological activity which often results in excessive LH-induced ovarian testosterone production which in turn can have a deleterious effect on egg/embryo “competency”.
      Certain ovarian stimulation regimes either promote excessive LH production (e.g. short agonist/Lupron- “flare” protocols, clomiphene and Letrozole), augment LH/hCG delivered through additional administration (e.g. high dosage menotropins such as Menopur), or fail to protect against body’s own/self-produced LH (e.g. late antagonist protocols where drugs such as Ganirelix/Cetrotide/Orgalutron that are first administered 6-7 days after ovarian stimulation has commenced).
      I try to avoid using such protocols/regimes (especially) in older women and those with DOR, favoring instead the use of a modified, long pituitary down-regulation protocol (the agonist/antagonist conversion protocol-A/ACP) augmented by adding supplementary human growth hormone (HGH). I further recommend Staggered IVF with embryo banking of PGS (next generation gene sequencing/NGS)-normal blastocysts in such cases. This type of approach will in my opinion, optimize the chance of a viable pregnancy per embryo transfer procedure and provide an opportunity to capitalize on whatever residual ovarian reserve and egg quality still exists, allowing the chance to “make hay while the sun still shines”.
      Please visit my new Blog on this very site, http://www.DrGeoffreySherIVF.com, find the “search bar” and type in the titles of any/all of the articles listed below, one by one. “Click” and you will immediately be taken to those you select. Please also take the time to post any questions or comments with the full expectation that I will (as always) respond promptly
      •Controlled Ovarian Stimulation (COS) for IVF: Selecting the ideal protocol
      •IVF: Factors Affecting Egg/Embryo “competency” during Controlled Ovarian Stimulation(COS)
      •The Fundamental Requirements For Achieving Optimal IVF Success
      •Ovarian Stimulation for IVF using GnRH Antagonists: Comparing the Agonist/Antagonist Conversion Protocol.(A/ACP) With the“Conventional” Antagonist Aproach
      •Anti Mullerian Hormone (AMH) Measurement to Assess Ovarian Reserve and Design the Optimal Protocol for Controlled Ovarian Stimulation (COS) in IVF.
      •The “Biological Clock” and how it should Influence the Selection and Design of Ovarian Stimulation Protocols for IVF.
      • A Rational Basis for selecting Controlled Ovarian Stimulation (COS) protocols in women with Diminished Ovarian Reserve (DOR)
      •Diagnosing and Treating Infertility due to Diminished Ovarian Reserve (DOR)
      •Controlled Ovarian Stimulation (COS) in Older women and Women who have Diminished Ovarian Reserve (DOR): A Rational Basis for Selecting a Stimulation Protocol
      •Human Growth Hormone Administration in IVF: Does it Enhances Egg/Embryo Quality and Outcome?
      •The BCP: Does Launching a Cycle of Controlled Ovarian Stimulation (COS). Coming off the BCP Compromise Response?
      •Blastocyst Embryo Transfers Should be the Standard of Care in IVF
      •Frozen Embryo Transfer (FET) versus “Fresh” ET: How to Make the Decision
      •Frozen Embryo Transfer (FET): A Rational Approach to Hormonal Preparation and How new Methodology is Impacting IVF.
      •Staggered IVF: An Excellent Option When. Advancing Age and Diminished Ovarian Reserve (DOR) Reduces IVF Success Rate
      •Embryo Banking/Stockpiling: Slows the “Biological Clock” and offers a Selective Alternative to IVF-Egg Donation.
      •Preimplantation Genetic Testing (PGS) in IVF: It Should be Used Selectively and NOT be Routine.
      •Preimplantation Genetic Sampling (PGS) Using: Next Generation Gene Sequencing (NGS): Method of Choice.
      •PGS in IVF: Are Some Chromosomally abnormal Embryos Capable of Resulting in Normal Babies and Being Wrongly Discarded?
      •PGS and Assessment of Egg/Embryo “competency”: How Method, Timing and Methodology Could Affect Reliability
      •Treating Out-of-State and Out-of-Country Patients at Sher-IVF in Las Vegas:
      •Traveling for IVF from Out of State/Country–
      •A personalized, stepwise approach to IVF
      •How Many Embryos should be transferred: A Critical Decision in IVF.
      •The Role of Nutritional Supplements in Preparing for IVF
      •Premature Luteinization (“the premature LH surge): Why it happens and how it can be prevented.
      •IVF Egg Donation: A Comprehensive Overview
      I invite you to arrange to have a Skype or an in-person consultation with me to discuss your case in detail. If you are interested, please contact Julie Dahan, at:

      Email: Julied@sherivf.com

      OR

      Phone: 702-533-2691
      800-780-7437

      I also suggest that you access the 4th edition of my book ,”In Vitro Fertilization, the ART of Making Babies”. It is available as a down-load through http://www.Amazon.com or from most bookstores and public libraries.

      Geoff Sher

      Good luck!

      Geoff Sher